Neutral functional realignment orthosis prevents hand pain in patients with subacute stroke: a randomized trial.
OBJECTIVE
To quantify the preventive effect of a neutral functional realignment orthosis on pain, mobility, and edema of the hand in subacute hemiparetic poststroke patients with severe motor deficits.


METHODS
Randomized trial.


METHODS
Rehabilitation center.


METHODS
Poststroke patients (N=30) with subacute hemiparesis and severe deficits of the upper limb were enrolled. Fifteen patients were randomized to a standard rehabilitation program without orthosis and 15 patients received an experimental orthosis in addition to their standard rehabilitation program.


METHODS
The orthosis group wore the neutral functional realignment orthosis for at least 6 hours daily.


METHODS
Hand pain at rest (visual analog scale), wrist range of motion (Fugl-Meyer Assessment subscale), and edema of hand and wrist (circumferences). Outcome measures were assessed at time of randomization and after 13 weeks between groups.


RESULTS
At baseline, 2 patients in each group complained about a painful hand. After 13 weeks, 8 subjects in the control group and 1 subject in the orthosis group complained of hand pain (P=.004). Mobility and edema evolved similarly in both groups.


CONCLUSIONS
Neutral functional realignment orthoses have a preventive effect on poststroke hand pain, but not on mobility and edema in the subacute phase of recovery.
Bürge
Elisabeth
E
Haute école de santé Geneva, HES-SO/University of Applied Sciences Western Switzerland, Geneva, Switzerland. Elisabeth.burge@hesge.ch
Kupper
Danièle
D
Finckh
Axel
A
Ryerson
Susan
S
Schnider
Armin
A
Leemann
Béatrice
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D009989:Orthotic Devices; D010146:Pain / Q000503:physiopathology* / Q000534:rehabilitation*; D010147:Pain Measurement; D010291:Paresis / Q000503:physiopathology* / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome